BRIGHTON — A doctor's order that Monica Chavez follow up with a neurologist didn't make it onto written instructions provided to the woman after an incident almost exactly five years before she suffered a seizure-like episode before a car crash that killed a family of five.

"They don't specifically say that, no," said Dr. Brian Williams during a second day of witness testimony in the trial of Chavez, who is charged with five counts of criminally negligent homicide and two counts of child abuse.

The charges stem from a rush-hour crash Feb. 17, 2011, in Thornton. Chavez was driving near the intersection of Grant Street and East 84th Avenue where she hit a Mazda and then a median, sending her Ford Expedition airborne before landing on a pickup truck and then crashing into a mattress store.

The five members of the Stollsteimer family in the pickup truck — three children and their parents — died instantly.

Chavez's two children were treated for minor injuries.

After the fatal accident, investigators discovered that it may have not been Chavez's first seizure-like episode.

Williams saw Chavez on Feb. 19, 2006, at North Suburban Medical Center after she experienced a seizure-like episode at an Albertsons store.

Investigators found notes from 2006 written by Williams that included instructions for Chavez to avoid driving until cleared by a neurologist. He made that determination because his preliminary tests could not confirm with enough certainty that the episode had been a seizure, as opposed to a fainting spell.

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"I was about 80 percent sure it was a seizure," Williams told the jury.

His written notes also mentioned two specific neurologists that she could follow-up with, but those names and numbers also failed to appear on discharge papers.

Though Williams and registered nurse, Cynthia Reynolds, could not recall the specific interaction they had six years ago with Chavez, both testified today that they believe they would have talked to Chavez about it even if it wasn't on her written discharge instructions.

"Generally I will write down phone numbers and such on her copy, not on the copy here, kept by records, but I can't be sure I did in her case," Reynolds said.

Discharge papers signed by Chavez, do state "do not drive until cleared by neuro," but then also instruct Chavez to follow up with her regular physician at Clinica Campesina.

Dr. Carolyn Shepherd examined Chavez at the Clinica on Feb. 20, 2006.

"I felt I didn't have all the information, so I was wondering if she had had a seizure," Shepherd said. "I put that question in my notes."

After that visit which included a physical exam of neurological function — reflexes, touch and hearing that appeared normal — Shepherd instructed Chavez to follow up with her again if she experienced more of the same seizure-like episodes.

"It wasn't a classical presentation of a seizure," Shepherd said. "We often wait until a second episode to be sure."

After the 2006 incident, and before the 2011 crash, prosecutors believe there were other incidents that went unreported.

One incident that has been in question during trial occurred sometime in the late summer of 2010 — perhaps months before the accident — at a McDonalds when Chavez was walking in the parking lot on her way to rent a movie. Chavez did not go to a doctor following that incident.

During Tuesday's testimony, a Thornton police officer who did preliminary questioning of people at the scene of the accident also testified that Chavez's 12-year-old daughter, Serriah, told him she had seen her mom have a similar attack once before "at the house," though she couldn't pinpoint when that was.

After the accident, Chavez did see a neurologist at Denver Health Medical Center. Dr. Patrick Bosque, after numerous normal exams, felt the 2011 episode during the accident was a fainting spell. A month later, having more information about what Chavez experienced, in addition to information about a 2006 incident that he noted happened in "her kitchen," diagnosed her episodes as probable seizures.

When asked if he would have changed his diagnose with information about the episode in 2010, Bosque said no.

"One more wouldn't change it much," Bosque said. "Two seizures is enough to generally want to start an anti-convulsion medication, so with three seizures, one would be more inclined to start the anti convulsion medication."

However, having known about the 2010 incident, he said he may have started her medications earlier, along with an instruction to restrict driving for about six months, he said, which may or may not have run up to the date of the crash, depending on when the 2010 incident occurred.

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